Dalfó Baqué A, Gibert Llorach E, Vila Coll M A, Sabartés Saperas T
Grupo de Trabajo en Hipertensión Arterial Gòtic, Equipo de Atención Primaria Gòtic, ICS, Barcelona.
Aten Primaria. 2000 Jul-Aug;26(3):180-3. doi: 10.1016/s0212-6567(00)78638-0.
To determine the protagonism of the medical and nursing staff in the diagnosis and observation of hypertense patients in a primary care team.
Cross-sectional descriptive study.
Urban primary care team.
Two random samples, with 325 clinical histories, of the hypertense patients under observation in the centre in the years 1995 (N = 1992) and 1996 (N = 1994).
The following variables were gathered on which professional had conducted the following: the blood pressure triple take (BPTT), physical examination (weight, height and peripheral pulses), request for further tests, health education on factors of cardiovascular risk (FCR), changes in life-style, anamnesis on side-effects in patients under medical treatment, and the number of attendances. The following details of patients were recorded: age and sex, body mass index, known time of hypertension evolution, blood pressure figures at the start and finish of the periods.
33 people in 1995 (10.2%; 95% CI, 6.8-13.4) and 8 people in 1996 (2.4%; 95% CI, 1-4.8) were diagnosed with hypertension. Average visits per professional in each year was 2.8 and 2.9 for nursing, and 1.5 and 1.8 for the doctor. There was a record of BPTT in 75.6% of cases, analysis request, ECG and full physical examination in 50.5% of cases, tackling CRF in 56.9%, recommendations on changes in life-style in 85.2%, and anamnesis on side-effects in 26.1%. It was basically nursing personnel who conducted BPTT (79.8% in 1996). 1995 saw greater CRF intervention by nursing staff (49.4%; 95% CI, 42.8-56.3) than by medical staff (15.3%; 95% CI, 10.3-19.9). In the second year the figures became 57.5% (95% CI, 50.9-64.2) against 12.3% (95% CI, 7.8-16.7). The interventions on life-style changes and anamnesis on possible side-effects were mainly conducted by nursing staff, at 66.2% (95% CI, 60.2-72.3) against doctors at 25.7% (95% CI, 20.2-31.3).
The role of nursing staff is fundamental to the diagnosis and observance of hypertense patients in the primary care team.
确定医护人员在基层医疗团队对高血压患者的诊断及观察中的主导作用。
横断面描述性研究。
城市基层医疗团队。
两个随机样本，共325份病历，来自1995年（N = 1992）和1996年（N = 1994）在该中心接受观察的高血压患者。
收集以下变量信息，包括由哪位专业人员进行了以下操作：血压三次测量（BPTT）、体格检查（体重、身高和外周脉搏）、进一步检查申请、心血管风险因素（FCR）健康教育、生活方式改变、接受治疗患者的副作用问诊以及就诊次数。记录患者的以下详细信息：年龄和性别、体重指数、已知高血压病程时间、各阶段开始和结束时的血压数值。
1995年有33人（10.2%；95%可信区间，6.8 - 13.4）被诊断为高血压，1996年有8人（2.4%；95%可信区间，1 - 4.8）。每年每位护理专业人员的平均就诊次数分别为2.8次和2.9次，医生分别为1.5次和1.8次。75.6%的病例有血压三次测量记录，50.5%的病例有分析申请、心电图及全面体格检查，56.9%的病例处理心血管风险因素，85.2%的病例有生活方式改变建议，26.1%的病例有副作用问诊。基本上是护理人员进行血压三次测量（1996年为79.8%）。1995年护理人员对心血管风险因素的干预（49.4%；95%可信区间，42.8 - 56.3）多于医生（15.3%；95%可信区间，10.3 - 19.9）。第二年的数据分别为57.5%（95%可信区间，50.9 - 64.2）和12.3%（95%可信区间，7.8 - 16.7）。生活方式改变干预及可能副作用的问诊主要由护理人员进行，占66.2%（95%可信区间，60.2 - 72.3），医生占25.7%（95%可信区间，20.2 - 31.3）。
在基层医疗团队中，护理人员的作用对于高血压患者的诊断和观察至关重要。
